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Feature Cholera

Vaccine shortages worsen the deadliest cholera outbreaks in years

BMJ 2024; 385 doi: https://doi.org/10.1136/bmj.q1228 (Published 18 June 2024) Cite this as: BMJ 2024;385:q1228
  1. Jane Feinmann, freelance journalist
  1. London
  1. jane{at}janefeinmann.com

The worst cholera outbreaks in 20 years are highlighting the dire shortage of vaccine supplies and the problems of vaccine inequity and manufacturing. Jane Feinmann reports

It’s nearly 18 months since the World Health Organization (WHO) raised cholera to its highest health emergency level, grade 3, in January 2023 after recording the deadliest outbreaks for 20 years in 23 countries.

At a press conference two months later (March 2023), Philippe Barboza, WHO’s cholera lead and head of the Global Task Force on Cholera Control, warned that one billion people were at risk of dying from a preventable disease. Alongside “limited progress” in improving access to safe water and sanitation for the world’s poorest people, Barboza laid the blame for the crisis on the shortage of oral cholera vaccines at a time of unprecedented demand.

He called for a change in the way that cholera vaccine manufacturers are supported to produce larger quantities with less financial risk.1 “It shouldn’t be that complicated for a cheap vaccine to be produced in the amounts that are needed,” Barboza told The BMJ last year. “It’s not happening because of a lack of political will, and that needs to change.”

Barboza reiterated his impatience at a WHO press briefing in April. The situation today, he said, is a good indicator of the lack of commitment to control cholera. “If the vaccine is the indicator, we are in a worse position this year than 2023 or 2022.”

This impatience is shared by the organisations that support efforts to control cholera. In March, the International Coordinating Group on Vaccine Provision–—comprising the Red Cross, Médecins Sans Frontières, and Unicef—joined with WHO to call on vaccine manufacturers, governments, donors, and partners to fast-track additional production of affordable oral cholera vaccines with the same urgency and innovation that we …

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